Organization Active NPI

Primary Care Associates PC

  • Family Medicine Physician
  • Harriman, TN
National Provider Identifier
1801892609
Registry record updated Oct 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD005463 Issued in TN
Legal business name
PRIMARY CARE ASSOCIATES PC
Practice address
413 Devonia St
Harriman, TN 37748-2010
Phone
(865) 882-3211
Fax
(865) 882-9889
NPI assigned
Jun 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Kim Ziegler Walls, RHIT
Title
Office Manager
Phone
(865) 882-3211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD005463 TN Primary

Addresses

Primary practice location

413 Devonia St
Harriman, TN 37748-2010

Mailing address

413 Devonia St
Harriman, TN 37748-2010
Phone (865) 882-3211

Other identifiers 3

IdentifierTypeStateIssuer
2006767OtherTNBLUE CROSS
3373554MedicaidTN
CB4807OtherTNRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254960000000",
    "number": "1801892609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 DEVONIA ST",
            "city": "HARRIMAN",
            "state": "TN",
            "postal_code": "377482010",
            "telephone_number": "865-882-3211",
            "fax_number": "865-882-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 DEVONIA ST",
            "city": "HARRIMAN",
            "state": "TN",
            "postal_code": "377482010",
            "telephone_number": "865-882-3211",
            "fax_number": "865-882-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2009-10-08",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "ZIEGLER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "865-882-3211",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RHIT"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD005463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "2006767",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3373554",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB4807",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harriman, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.